The necessary and indispensable developments that the veterinarian working with ruminants must master in order to practice safely in surgery, with the peculiarities and specifications unique to this area"

In the process of training in veterinary medicine and, in particular, in ruminant or collective medicine, it is essential, before getting into more specific subjects, to acquire a series of clinical skills to face the different pathologies that will be addressed in this Postgraduate diploma. For this reason, it is essential to know the different diagnostic methods and, of course, the most appropriate alternatives for the treatment of the different pathologies. 

Taking into account the size and behavior of bovines, the first chapter deals with the methods of immobilization of these, for their examination or even the approach of minor surgical processes or podiatry. It must be taken into account that 90% of the procedures are ambulatory, therefore it is essential to know the basic material necessary to be able to carry out all the interventions correctly and efficiently. 

The surgery of animals for slaughter has progressed enormously with technological advances such as laparoscopy, teloscopy or ultrasound diagnosis even in field surgery.
It is essential to emphasize the importance of animal welfare, which is already taken for granted by veterinarians, farmers and the general public. The patient should know the basics of pain and its appropriate management through sedation and analgesia techniques, and the surgical procedures necessary to resolve the pre-existing pathology.

This Postgraduate diploma reviews the principles of ruminant surgery and reviews diagnostic procedures, surgical indications, operative techniques and postoperative management in digestive, skin, ocular, umbilical, male and female genital, and urinary tract surgery.

The module in Surgery of the Musculoskeletal System deals with the processes that affect the limbs of ruminants and compromise their welfare and productivity. The study includes everything from the anatomy and biomechanics of the hoof, preventive management and diagnosis and treatment of podiatric conditions to tendon, joint and bone conditions, to emergency treatment of bone fractures, as well as prognosis and surgical options for long bone fractures.

Essential yet rare training for the specialist veterinary clinician that will set you apart as a specialist in this field of work"

This Postgraduate diploma in Ruminant Surgery contains the most complete and up-to-date scientific program on the market. The most important features include:

• The latest technology in online teaching software
• A highly visual teaching system, supported by graphic and schematic contents that are easy to assimilate and understand
• The development of practical case presented by experts
• State-of-the-art interactive video systems
• Teaching supported by telepractice
• Continuous updating and recycling systems
• Autonomous learning: full compatibility with other occupations
• Practical exercises for self-assessment and learning verification
• Support groups and educational synergies: questions to the expert, debate and knowledge forums
• Communication with the teacher and individual reflection work
• Content that is accessible from any fixed or portable device with an internet connection
• Supplementary documentation databases are permanently available, even after the Postgraduate Diploma has finished 

The clinical, specialized and advanced fundamentals, based on veterinary evidence that will allow you to face the daily intervention in cattle and ruminants"

Our teaching staff is made up of professionals from different fields related to this specialty. In this way, TECH makes sure to offer professionals the up-to-date objective it intends. A multidisciplinary team of professionals trained and experienced in different environments who will develop theoretical knowledge efficiently, but, above all, will provide students with practical knowledge derived from their teaching experience: one of the differential qualities of this program.

This mastery of the subject is complemented by the effectiveness of the methodological design. Developed by a multidisciplinary team of e-Learning experts, it integrates the latest advances in educational technology. In this way, the student will be able to study with comfortable and versatile multimedia tools that will give them the operability they need in their training. 

The design of this program is based on Problem-Based Learning: an approach that conceives learning as a highly practical process. To achieve this remotely telepractice will be used: with the help of an innovative system of interactive videos and learning from an expert you will be able to acquire the knowledge as if you were facing the case you are learning at that moment. A concept that will make it possible to integrate and fix learning in a more realistic and permanent way.

With a methodological design based on proven teaching techniques, this innovative program will take you through different teaching approaches to allow you to learn in a dynamic and effective way"

Supported by evidence, the approach of this program will allow you to learn in a contextual way and acquire the skills you will really need in your daily practice"

The contents have been developed by the different experts of this Postgraduate diploma, with a clear purpose: to ensure that students acquire each and every one of the skills necessary to become true experts in this field.

A comprehensive and well-structured program that will lead the professional to the highest standards of quality and success. 

A comprehensive teaching program, structured in well-developed teaching units, oriented towards learning that is compatible with your personal 
and professional life"

Module 1. Clinical Skills

1.1. Handling and Restraint of Cattle

1.1.1. Introduction
1.1.2. Physical Immobilization Methods

1.1.2.1. Head
1.1.2.2. Limbs
1.1.2.3. Immobilization Devices

1.1.3. Animal Takedown

1.1.3.1. Takedown Systems
1.1.3.2. Handling in Decubitus Position

1.2. Veterinary Equipment in Field Clinics

1.2.1. Introduction
1.2.2. Examination Material
1.2.3. Surgical Material 
1.2.4. Obstetrical Material

1.2.4.1. Childbirth
1.2.4.2. Insemination
1.2.4.3. Breeder Assessment

1.2.5. Sample Extraction Material
1.2.6. Drug Administration Material
1.2.7. Fluid Therapy Material
1.2.8. Medication

1.2.8.1. Antibiotic Therapy
1.2.8.2. Anti-Inflammatories
1.2.8.3. Hormonal
1.2.8.4. Metabolic and Vitamin
1.2.8.5. Antiparasitics II

1.3. Herd Health Research

1.3.1. Introduction 
1.3.2. Definition of Health and Disease 
1.3.3. Animal Welfare: Indicators and Determinants 

1.3.3.1. Stress 
1.3.3.2. Management 
1.3.3.3. Hygiene 
1.3.3.4. Transport 

1.3.4. Health 

1.3.4.1. Disease Transmission 
1.3.4.2. Registration and Controls 
1.3.4.3. Individual and Herd Clinical Assessment 
1.3.4.4. Complementary Tests 
1.3.4.5. Reporting and Monitoring

1.4. Diagnosis and Clinical Reasoning

1.4.1. Introduction
1.4.2. Diagnostic Process

1.4.2.1. Clinical Examination
1.4.2.2. Hypothetical-Deductive Reasoning
1.4.2.3. Archive

1.4.3. Reasoning Patterns

1.4.3.1. Pattern Recognition Methods
1.4.3.2. Probability 
1.4.3.3. Pathophysiological Reasoning

1.4.4. Clinical Signs and Diagnostic Tests

1.4.4.1. Logical Exclusion of Disease
1.4.4.2. Inductive-Deductive Reasoning

1.4.5. Errors
1.4.6. Clinical Reasoning Exercise

1.4.6.1. Clinical Scenarios
1.4.6.2. Clinical Examination 
1.4.6.3. Clinical reasoning

1.5.    Special Diagnostic Procedures

1.5.1. Introduction
1.5.2. Skin
1.5.3. Cardiovascular

1.5.3.1. Percussion
1.5.3.2. Electrocardiography
1.5.3.3. Ultrasound
1.5.3.4. Radiography
1.5.3.5. Pericardiocentesis
1.5.3.6. Blood Culture

1.5.4. Respiratory System

1.5.4.1. Bronchoalveolar Lavage
1.5.4.2. Parasitological Tests
1.5.4.3. Nasal Swabs
1.5.4.4. Radiography
1.5.4.5. Ultrasound
1.5.4.6. Thoracentesis
1.5.4.7. Biopsy
1.5.4.8. Bio Markers

1.5.5. Abdomen

1.5.5.1. Rectal Examination
1.5.5.2. Rumen Fluid Analysis
1.5.5.3. Abdominocentesis
1.5.5.4. Radiography
1.5.5.5. Hepatic Biopsy
1.5.5.6. Liver Function Test
1.5.5.7. Urinary

1.5.6. Mammary Glands

1.5.6.1. California Mastitis Test
1.5.6.2. Conductivity
1.5.6.3. Collection for Microbiological Analysis

1.5.7. Musculoskeletal System

1.5.7.1. Arthrocentesis

1.5.8. Cerebrospinal Fluid Analysis

1.6. Antimicrobial Therapy in Cattle

1.6.1. Introduction
1.6.2. Characteristics of the Different Groups of Antimicrobials    

1.6.2.1. Sulfonamides
1.6.2.2. Penicillins
1.6.2.3. Tetracyclines
1.6.2.4. Macrolides
1.6.2.5. Aminoglycosides
1.6.2.6. Cephalosporins
1.6.2.7. Lincosamides

1.6.3. Categorization of Antibiotics According to the Risk of their Use
1.6.4. Selection of an Antimicrobial According to the Process
1.6.5. Bacterial Resistance to Antimicrobials

1.7. Fluid Therapy.

1.7.1. Introduction
1.7.2. Fluid Therapy in Calves

1.7.2.1. Lactic Acidosis in Calves 

1.7.3. Fluid Therapy in Adult Cattle

1.7.3.1. Sodium Balance and Dysnatremias
1.7.3.2. Hypokalemic Syndrome in Cattle
1.7.3.3. Calcium and Magnesium Disorders
1.7.3.4. Treatment of Phosphorus Balances

1.7.4. Fluid Therapy in Small Ruminants
1.7.5. Use of Blood and Blood Products in Ruminants

1.8. Analgesia

1.8.1. Assessment of Pain in Cattle
1.8.2. Negative Effects of Pain

1.8.2.1. Chronic Pain
1.8.2.2. Acute Pain

1.8.3. Strategies for the Treatment of Pain

1.8.3.1. Preventive Analgesia
1.8.3.2. Multimodal or Balanced Analgesia. Analgesic Drugs
1.8.3.3. Opioids

1.8.3.3.1. Pure Agonists
1.8.3.3.2. Partial Agonists

1.8.3.4. α2-Agonists: Xylazine, Detomidine
1.8.3.5. NSAIDs: Ketoprofen, Carprofen, Meloxicam
1.8.3.6. Local Anesthetic. Lidocaine
1.8.3.7. Dissociative Anesthetics. Ketamine

1.8.4. Local anesthetics

1.8.4.1. Transduction
1.8.4.2. Peripheral of Conduction Blockages
1.8.4.3. Intravenous Regional Anesthesia
1.8.4.4. Nerve Blocks
1.8.4.5. Epidural Administration of Drugs
1.8.4.6. α2-Agonists:    

1.8.4.6.1. α2-Agonists Mechanism of Action, Adverse Effects, Antagonists
1.8.4.6.2. Routes of Administration. Epidural, IV, IM, SC

1.8.5. Combination with Other Drugs: Local Anesthetics, Opiates, Ketamine 

1.8.5.1. NSAIDs
1.8.5.2. Mechanism of Action
1.8.5.3. Types of NSAIDs
1.8.5.4. Central Modulatory Inhibitory Effect
1.8.5.5. Preoperative and Postoperative Application
1.8.5.6. Anesthetics 

1.9. Sedation and Anesthesia Effect

1.9.1. Introduction
1.9.2. Pharmacological Immobilization

1.9.2.1. Means of Teleapplication

1.9.2.1.1. Directly in a Crate or Sleeve Handle
1.9.2.1.2. By Syringe
1.9.2.1.3. At a Distance, Applying Darts with the Drug

1.9.3. Animal in Decubitus or Standing Animal

1.9.3.1. Tranquilization Methods
1.9.3.2. Animal Standing Combining Sedative and Local Anesthesia Techniques

1.9.4. Pharmacological Immobilization plus Locoregional Anesthesia

1.9.4.1. The α2-Receptor Agonist Tranquilizers: Xylazine, Detomidine, Romifidine, Medetomidine
1.9.4.2. Advantages of α2-Receptor Agonists

1.9.4.2.1. Volume
1.9.4.2.2. Sedative Effect
1.9.4.2.3. Analgesic
1.9.4.2.4. Mixed
1.9.4.2.5. Antagonizable

1.9.4.3. Disadvantages of α2-Receptor Agonists
1.9.4.4. Intraoperative and Postoperative Analgesia

1.9.4.4.1. α2, Opiates, Ketamine and Tiletamine.
1.9.4.4.2. Local and Regional Anesthesia
1.9.4.4.3. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

1.10. Local and Regional Analgesia

1.10.1. Incision Line Infiltration Blockage
1.10.2. Inverted Block

1.10.2.1. Inverted L-Block
1.10.2.2. Paravertebral Block

1.10.2.2.1. Proximal and Distal Paravertebral Anesthesia
1.10.2.2.2. Dorsal and Ventral Branch Blockage

1.10.3. Epidural Anesthesia

1.10.3.1. Administration
1.10.3.2. Localisation
1.10.3.3. Indications
1.10.3.4. The Doses
1.10.3.5. Duration of Effect
1.10.3.6. Applied Pharmacological Combinations

1.10.4. Anesthetics

1.10.4.1. Ketamine
1.10.4.2. Tietamine
1.10.4.3. Etorphine. Prohibited for Use, Possession and Commercialization

1.10.4.3.1. Withdrawn from the Market in 2005

1.10.5. Update on Anesthesia in Cattle and Other Ruminants

1.10.5.1. New Anesthetic Protocol
1.10.5.2. Anesthetic Model
1.10.5.3. Anesthetic Combination. Phencyclidines-Detomidine

1.10.5.3.1. Zolazepam-Tiletamine
1.10.5.3.2. Ketamine
1.10.5.3.3. Detomidine

1.10.6. Maintaining the Anesthesia

1.10.6.1. Dosage
1.10.6.2. Antagonization

1.10.6.2.1. Precautions
1.10.6.2.2. Basic Anesthetic Monitoring

1.10.7. Anesthetic Depth

1.10.7.1. Cardiovascular System
1.10.7.2. Heart Rate
1.10.7.3. Peripheral Pulse Palpation
1.10.7.4. Capillary Refill Time
1.10.7.5. Respiratory System
1.10.7.6. Respiratory Rate and Pattern
1.10.7.7. Mucosal Color
1.10.7.8. Electronic Monitors: Portable Pulse Oximeter

 Module 2. Soft Tissue Surgery

2.1. The Surgery. Pre-Operative, Field Preparation, Surgeon Preparation

2.1.1. Pre-surgery Planning
2.1.2. Surgical Attire, Preparation of Surgical Equipment: Gloves, Gowns etc.
2.1.3. Preparation of the Patient and Surgical Area

2.2. Surgery of the Pre-Stomachs. Peritonitis

2.2.1. Surgical Physiology and Anatomy
2.2.2. Pathology and Clinical Signs
2.2.3. Surgical Techniques

2.2.3.1. Left Flank Laparotomy
2.2.3.2. Ruminotomy

2.2.4. Perioperative Management
2.2.5. Peritonitis

2.3. Abomasal Surgery. Laparoscopy

2.3.1. Pathogenesis of Abomasal Displacements
2.3.2. Types of Abomasal Displacements

2.3.2.1. Left Displacement of the Abomasum
2.3.2.2. Dilatation/Displacement of the Right Abomasum

2.3.2.2.1. Volvulus of the Right Side of the Abomasum

2.3.3. Clinical Introduction and Diagnosis
2.3.4. Management of Abomasal Displacements

2.3.4.1. Physical Methods
2.3.4.2. Medical Therapy
2.3.4.3. Surgical Techniques
2.3.4.4. Right Flank Omentopexy
2.3.4.5. Right Flank Pyloropexy
2.3.4.6. Left Flank Abomasopexy
2.3.4.7. Right Median Abomasopexy

Module 3. Musculoskeletal System Surgery

3.1. Anatomy and Biomechanics of the Hoof. Functional Trimming

3.1.1. Anatomy and Biomechanics of the Hoof

3.1.1.1. Anatomical Structure. Key Structures
3.1.1.2. Hoof

3.1.1.2.1. Corion
3.1.1.2.2. Other Structures

3.1.1.3. Biomechanics

3.1.1.3.1. Concept
3.1.1.3.2. Hind Limbs Biomechanics
3.1.1.3.3. Fore Limbs Biomechanics

3.1.1.4. Factors that Affect Biomechanics 

3.1.2. Functional Trimming

3.1.2.1. Concept and Importance of Functional Trimming
3.1.2.2. Trimming Technique. Dutch Model
3.1.2.3. Other Trimming Techniques
3.1.2.4. Containment and Instrumentation

3.2. Diseases of the Hoof I. Infectious Origin: Digital Dermatitis. Interdigital Dermatitis. Interdigital Phlegmon

3.2.1.    Digital Dermatitis.

3.2.1.1. Etiology
3.2.1.2. Clinical Signs
3.2.1.3. Control
3.2.1.4. Treatment

3.2.2.    Interdigital Dermatitis.

3.2.2.1. Etiology
3.2.2.2. Clinical Signs
3.2.2.3. Control
3.2.2.4. Treatment

3.2.3. Interdigital Phlegmon 

3.2.3.1. Etiology
3.2.3.2. Clinical Signs
3.2.3.3. Control
3.2.3.4. Treatment

3.2.4. Use of Footbath for the Control of Environmental Diseases 

3.2.4.1. Design
3.2.4.2. Products

3.3.    Diseases of the Hoof II. Non-Infectious Origin: Sole Ulcer. White Line Disease. Point Ulcers and Others

3.3.1. Sole Ulcers

3.3.1.1. Etiopathogenesis
3.3.1.2. Control
3.3.1.3. Treatment

3.3.2. White Line Disease

3.3.2.1. Etiopathogenesis
3.3.2.2. Control
3.3.2.3. Treatment

3.3.3. Other Diseases of Non-Infectious Origin

3.3.3.1. Hyperconsumption or Thin Sole
3.3.3.2. Point Ulcers
3.3.3.3. Ring-Shaped Hooves

3.4. Surgical Treatment of Septic Processes of the Distal Limb ( Finger Amputation, Distal and Proximal Interphalangeal Joint Ankylosis)

3.4.1. Aetiology of Septic Processes of the Distal Limb
3.4.2. Diagnosis

3.4.2.1. Clinical Presentation
3.4.2.2. Diagnostic Imaging
3.4.2.3. Clinical Pathology

3.4.3. Indications for Distal Limb Surgery
3.4.4. Surgical preparation
3.4.5. Treatment in Acute Septic Processes

3.4.5.1. Joint Lavage
3.4.5.2. Systemic Antibiotics

3.4.6. Surgical Treatment in Chronic Septic Processes

3.4.6.1. Amputation of the Digit
3.4.6.2. Arthrodesis/Facilitated Ankylosis

3.4.6.2.1. Solar Approach
3.4.6.2.2. Bulbar Approach
3.4.6.2.3. Dorsal Approach

3.4.6.2.3.1. Abaxial Approach
3.4.6.2.3.2 Prognosis

3.5. Examination of Lameness. Diagnosis and Prognosis of Proximal Limb Injuries

3.5.1.    Examination of Lameness
3.5.2.    Diagnostic Tests

3.5.2.1. Synovial Fluid
3.5.2.2. Radiographic Diagnosis
3.5.2.3. Ultrasound Diagnosis

3.5.3.    Diagnosis and Prognosis of Proximal Limb Injuries

3.6. Cranial Cruciate Ligament Rupture. Upward Patella Fixation. Coxofemoral Dislocation. Femoral Neck Fracture

3.6.1. Cranial Cruciate Ligament Damage

3.6.1.1. Imbrication of Patella
3.6.1.2. Cranial Cruciate Ligament Replacement

3.6.1.2.1. Gluteobiceps Replacement
3.6.1.2.2. Synthetic Ligament

3.6.1.3. Postoperative Care and Prognosis

3.6.2. Coxofemoral Dislocation
3.6.3. Dorsal Dislocation of Patella
3.6.4. Fracture of the Femoral Neck and Head

3.6.4.1. Clinical Signs
3.6.4.2. Surgical Approach
3.6.4.3. Surgical Techniques
3.6.4.4. Femoral Head Ostectomy
3.6.4.5. Post-Operative Management and Complications

3.7. Management of Septic Arthritis. Septic Tenosynovitis. Arthroscopy. Osteochondrosis. Osteoarthritis

3.7.1. Etiology 
3.7.2. Diagnosis
3.7.3. Medical and Surgical Treatment 
3.7.4. Prognosis
3.7.5. Complications, Osteomyelitis
3.7.6. Other Joint Pathologies 

3.7.6.1. Osteochondrosis in Fattening Calves
3.7.6.2. Poly and Oligoarthrosis

3.8. Tendon Surgery: Hyperextension, Flexural Deformities, Arthrogryposis, Lacerations. Spastic Paresis

3.8.1. Tendon Lacerations Management and Repair

3.8.1.1. Diagnosis
3.8.1.2. Tendon Avulsion and Rupture
3.8.1.3. Treatment

3.8.2. Hyperextension

3.8.2.1. Diagnosis
3.8.2.2. Treatment

3.8.3. Flexural Deformities

3.8.3.1. Types 
3.8.3.2. Diagnosis
3.8.3.3. Treatment

3.8.4. Arthrogryposis

3.8.4.1. Diagnosis
3.8.4.2. Treatment

3.8.5. Spastic Paresis

3.8.5.1. Diagnosis
3.8.5.2. Treatment

3.9. Emergency Treatment of Fractures. Principles of Fracture Repair 

3.9.1. Introduction to Fracture Management in Cattle
3.9.2. Emergency Treatment
3.9.3. Diagnostic Imaging
3.9.4. Principles of Fracture Management

3.9.4.1. Hoof Blocks
3.9.4.2. Plaster
3.9.4.3. Thomas Splint (Thomas Schroder Splint)
3.9.4.4. External Fixators

3.9.5.    Thomas Splint

3.9.5.1. Application
3.9.5.2. Practical Advice
3.9.5.3. Complications

3.9.6.    Guidelines for Use of External Fixation in Long Bone Fractures

3.9.6.1. Advantages
3.9.6.2. Disadvantages
3.9.6.3. Types of External Fixators

3.9.7. Transfixion Plasters

3.9.7.1. Application
3.9.7.2. Practical Considerations in Bovines

3.9.8. Complications Associated with External Fixators

3.10. Resolution of Specific Fractures: Decision Making and Guidance for External Skeletal Fixation. Plasters and Plasters with Transfixing Pins. Plates, Intramedullary Nails and Locking Nails

3.10.1. Resolution of Specific Fractures 

3.10.1.1. External Coaptation
3.10.1.2. Placement of Acrylic Casts 
3.10.1.3. Complications of Acrylic Casts
3.10.1.4. Removal of Acrylic Casts
3.10.1.5. External Fixators
3.10.1.6. Indications
3.10.1.7. Biomechanics of External Fixators
3.10.1.8. External Fixators
3.10.1.9. Application
3.10.1.10. Post-Positioning Care
3.10.1.11. Complications
3.10.1.12. Removal of External Fixator
3.10.1.13. Acrylic Frame Fixatros
3.10.1.14. Transfixion Casts
3.10.1.15. Implants
3.10.1.16. Plates
3.10.1.17. Screws
3.10.1.18. Intramedullary Nails
3.10.1.19. Locked Nails.
3.10.1.20. Complications of Internal Fixations

3.10.1.20.1. Infections

3.10.2. Failure or Migration 
3.10.3. Prognosis

A unique specializacion program that will allow you to acquire advanced training in this field"